Year: 2025 | Month: June | Volume: 12 | Issue: 6 | Pages: 109-118
DOI: https://doi.org/10.52403/ijrr.20250613
Impact of Early Mobilization Versus Immobilization After Upper Limb Fractures: A Systematic Review of Functional Recovery
Anak Agung Ngurah Bagus Surya Darma1, Anak Agung Gede Yuda Asmara2
1Resident, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
2Orthopaedic Surgeon, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
Corresponding Author: Anak Agung Ngurah Bagus Surya Darma
ABSTRACT
Introduction: Optimal timing of mobilization following upper limb fractures remains a subject of debate in orthopedic rehabilitation. While early mobilization is hypothesized to accelerate functional recovery and reduce stiffness, concerns regarding fracture healing and complications persist. This systematic review aims to evaluate the impact of early mobilization versus immobilization on functional recovery in patients with upper limb fractures.
Methods: A systematic search was conducted across PubMed, Scopus, and Cochrane Library databases up to April 2025. Inclusion criteria comprised randomized controlled trials (RCTs), cohort studies, and systematic reviews comparing early mobilization (initiated within 7 days post-injury or surgery) to standard or delayed mobilization in adult patients with upper limb fractures, including proximal humerus and distal radius fractures. Outcomes of interest included pain, range of motion (ROM), functional scores (DASH, Constant-Murley), and complication rates.
Results: Nine studies met inclusion criteria, encompassing a total of 712 patients. Among patients with proximal humerus fractures managed conservatively, early mobilization resulted in significant improvement in pain and shoulder function within the first 3 months post-injury. In surgically treated distal radius fractures, early rehabilitation was associated with faster return of wrist motion and improved upper limb function, although long-term outcomes were similar between groups. Complication rates, including malunion and stiffness, did not significantly differ between early and delayed mobilization groups.
Conclusion: Early mobilization following upper limb fractures, particularly in the proximal humerus and distal radius, appears to be safe and offers short-term functional benefits without increasing complication rates. However, long-term outcomes remain inconclusive, and variability in rehabilitation protocols limits standardization. Further high-quality RCTs are necessary to define optimal mobilization timing across various fracture types and treatment modalities.
Keywords: Early mobilization, immobilization, upper limb fractures, proximal humerus, distal radius, rehabilitation, functional recovery, orthopedic
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